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in January Dave Regan, president of SEIU-United Healthcare Workers West, announced the launch of two ballot initatives to cap hospital pricing and executive salaries. The union canceled those efforts when it made a deal with the California Hospital Association in May. Adrian Florido

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The informal partnership between one of California’s leading health care unions and the California Hospital Association has drawn mixed reviews, with some praising the deal between the traditional adversaries, and others saying the union is getting too cozy with management.

The centerpiece of its deal with the Hospital Association, announced last month, is a $100 million joint lobbying effort seeking higher reimbursement rates for Medi-Cal providers.

"This really represents a new way forward on how we might be able to solve big problems in California like the Medi-Cal problem, together rather than working at cross purposes," said union spokesman Steve Trossman.

Duane Dauner, the Association's president and CEO, praised the agreement, and said he was pleased to be working with the union on the Medi-Cal issue.

For its part, the union agreed to drop its $5 million effort to get two initiatives on the November ballot. More than 500,000 signatures collected across the state were set aside. The measures aimed to cap hospital fees and the salaries of hospital executives.

In addition to the agreement on the joint Medi-Cal effort, the deal includes a code of conduct. Trossman said it provides guidance on how the two groups must treat one another during union organization efforts; for example, they agreed to refrain from making negative comments about each other during union organizing campaigns. At the same time, Hospital Association spokeswoman Jan Emerson-Shea stressed that the agreement does not provide the union with "guaranteed access" to non-union workers inside hospitals.

Beyond that, little is known about the agreement. The leaders of the two groups have kept the text secret, even from the union’s rank-and-file.

The deal has won some support. Vanessa Aramayo heads the California Partnership, a coalition of community groups that had backed the ballot initiatives. She said the compromise was worth getting the hospital association to join in the Medi-Cal lobbying effort.

"It doesn’t make sense if we can get millions of people newly enrolled if they don’t have anywhere to go because provider rates are so low and doctors don’t want to take Medi-Cal patients," said Aramayo.

In a statement, California Labor Federation chief Art Pulaski also pointed to the Medi-Cal campaign as the reason why he supports the agreement.

Some in the health care labor movement refused to discuss the deal publicly. And several elected officials who had backed the ballot initiatives also declined to comment.

The deals’ critics are unhappy that SEIU dropped the ballot measures, and they believe the union is making a strategic mistake by working so closely with the Hospital Association.

"This is a very stark contrast between how the union movement had operated and the way this union [is] going," said Jamie Court, president of Consumer Watchdog.

Court also criticized the way the union made its deal with the hospital group.

"It’s a mistake to go into a closed door back room type of deal where the public doesn’t have a say and the public can’t help you if you are a union who represents workers who take care of the public," he said.

This is not the first time the union and the Hospital Association have paired up. Two years ago SEIU dumped another ballot initiative in exchange for a promise that the Association would facilitate union meetings with the heads of hospitals SEIU wanted to organize.

Union spokesman Trossman said that deal did not work out as planned. But this time, he said, things are different because of who signed the agreement.

"It’s not just with the hospital association, but the agreement has been signed between SEIU, CHA and a number of individual hospitals and hospital systems," he said. "So we have a direct agreement with those systems."

The hospital association and the union won’t reveal the names of the hospitals that signed the deal, although Trossman said they account for the majority of hospital beds in the state.

"The hospitals that have signed on represent hospitals that are in excess of 30,000 unorganized workers," he said.

One of the SEIU’s union adversaries says that’s what this deal is really about.

"It simply helps the union as an organization, it’s company unionism," said Sal Roselli, president of the rival National Union of Healthcare Workers. "The union gains more dues payers; it’s all about numbers."

Trossman dismissed Roselli’s criticism. He insisted that the deal is meant to benefit patients, health care workers, and hospitals.

SEIU President Dave Regan says if the agreement with the hospital association doesn’t work out, the union can always return to the initiative process.